Impact of left atrial appendage morphology on thrombus formation in TAVI patients with atrial fibrillation

European Journal of Medical Research

Research

M. Seyfarth¹  N. Abanador-Kamper¹  P. Haage²  L. Kamper²  J. Bepperling³ 

[1] Cardiology & Heart Center, HELIOS University Hospital Wuppertal, University Witten/Herdecke, Witten, Germany;Diagnostic & Interventional Radiology, HELIOS University Hospital Wuppertal, University Witten/Herdecke, Heusnerstr. 30, 42883, Wuppertal, Germany;Gynaecology, Marien Hospital Witten, University Witten/Herdecke, Witten, Germany;

关键词: Left atrial appendage;    Atrial fibrillation;    Risk assessment;    Thrombus;    Stroke;   

DOI  :  10.1186/s40001-023-01057-y

 received in 2023-02-01, accepted in 2023-02-09,  发布年份 2023

来源: Springer

【 摘 要 】

PurposeWe aimed to correlate left atrial appendage (LAA) morphology with thrombus formation in patients with severe aortic valve stenosis and atrial fibrillation.MethodsWe analyzed LAA morphology and the prevalence of a thrombus in 231 patients with atrial fibrillation and severe aortic valve stenosis that were referred for pre-interventional CT scan before trans-catheter aortic valve implantation (TAVI) between 2016 and 2018. In addition, we documented neuro-embolic events depending on the presence of LAA thrombus within a follow-up of 18 months.ResultsThe overall distribution of different LAA morphologies was chicken-wing 25.5%, windsock 51.5%, cactus 15.6% and cauliflower 7.4%. Compared to chicken-wing morphology, patients with non-chicken-wing morphology showed a significantly higher thrombus rate (OR: 2.48, 95%; CI 1.05 to 5.86, p = 0.043). Within the 50 patients with a LAA thrombus, we observed chicken-wing (14.0%), windsock (62.0%), cactus (16.0%) and cauliflower (8.0%) configuration. In patients with LAA thrombus those with chicken-wing configuration have a higher risk (42.9%) to develop neuro-embolic events compared to non-chicken-wing configuration (20.9%).ConclusionWe found a lower LAA thrombus rate in patients with chicken-wing morphology compared to patients with non-chicken-wing configuration. However, in the presence of thrombus, those patients with chicken-wing morphology showed a doubled risk for neuro-embolic events compared to patients with non-chicken-wing morphology.These results must be confirmed in larger trials but underline the importance of LAA evaluation in thoracic CT scans and could have an impact on the anticoagulation management.

【 授权许可】

CC BY   
© The Author(s) 2023

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